Individual provider Active NPI

Robert Hynick, DO

  • Family Medicine Physician
  • Muncy, PA
National Provider Identifier
1679555296
Registry record updated Oct 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
05004400L Issued in PA
Practice address
2796 Lycoming Mall Dr
Muncy, PA 17756-6466
Phone
(570) 546-5454
Fax
(570) 546-5468
NPI assigned
Nov 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 05004400L PA Primary

Addresses

Primary practice location

2796 Lycoming Mall Dr
Muncy, PA 17756-6466

Mailing address

2796 Lycoming Mall Dr
Muncy, PA 17756-6466
Phone (570) 546-5454

Other identifiers 2

IdentifierTypeStateIssuer
1684769OtherPABLUE SHIELD
P00176021OtherPARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
05004400LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Twin Hills Chiropractic Health Center, P.C. PastSince Apr 30, 2003 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350518400000",
    "number": "1679555296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2796 LYCOMING MALL DR",
            "city": "MUNCY",
            "state": "PA",
            "postal_code": "177566466",
            "telephone_number": "570-546-5454",
            "fax_number": "570-546-5468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2796 LYCOMING MALL DR",
            "city": "MUNCY",
            "state": "PA",
            "postal_code": "177566466",
            "telephone_number": "570-546-5454",
            "fax_number": "570-546-5468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYNICK",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2012-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "05004400L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "1684769",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00176021",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muncy, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.